The inspection took place on 21 September and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger adults with disabilities. At the time of our inspection IRC Care were supporting 46 people.

There was a registered manager in post who supported us during the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our inspection on 23 February 2017 we found that quality assurance checks were not being regularly completed and that records management was inconsistent. Following the inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of well-led to at least good. At this inspection we found there had not been sufficient improvements in these areas and the service continued to breach this regulation. In addition, we identified a further two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Quality assurance processes were not always effective in ensuring that any shortfalls in the service were identified and acted upon. No audits were completed which meant areas which were in need of improvement such as staff spot checks and training had not been identified. Spot checks on staff performance were not completed regularly in order to monitor staff competence. Staff did not receive induction and training in line with the providers policy and the supervision of staff was not completed at the stated intervals.

Not all staff we spoke to were knowledgeable about safeguarding processes. Some staff were unable to tell us the different types of potential abuse people may experience and were not aware of how to report concerns to outside agencies.

Although risks to people’s safety were managed well, staff did not always receive guidance on the action to take when supporting people with specific health conditions. Care records did not always contain personalised information about people and their backgrounds. There was little information within people’s care records regarding the care they wished for at the end of their lives. We have made recommendations regarding these areas of people’s care.

Sufficient staff were employed to meet people’s care calls. People and their relatives told us that on the whole staff arrived on time and stayed for the planned duration of the call. Safe recruitment practices were followed to ensure staff employed by the provider were suitable to work at the service. Staff were supported by an on-call service which provided assistance when working out of hours. The provider had processes to follow in the event of unforeseen circumstances occurring such as severe weather or IT failure.

Accidents and incidents were recorded, reviewed and action taken to minimise the risk of them happening again. Safe infection control procedures were followed and staff had access to personal protective equipment. Environmental risk assessments were completed which considered risks to both staff and people receiving care. Where people required support with their medicines this was provided safely and records were clear. Where required people were supported to access healthcare professionals and guidance provided was followed.

People’s needs were assessed prior to people receiving a service to ensure they could be met. Care plans contained details of the care people required and staff recorded this had been completed at the end of each care call. Where people’s needs changed, responsive action was taken to provide them with the support and equipment required to provide their care. Pe

IRC Care Services is a care agency that provides domiciliary care and support to people so that they can live independently in their own homes.

People who receive a service in their own homes include those living with physical support needs. The agency also provides services to people living with dementia and those who may have mental health needs. At the time of our inspection 40 people received care and support in accordance with the regulated activity of personal care.

The inspection took place on 23 February 2017. The provider was given forty eight hours’ notice of the inspection.

There was a not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had been in post for two weeks, and had begun the registration process with CQC.

The lack of a registered manager had an impact on the service as the systems in place to monitor the quality of care and support that people received were not as well managed as they could be. Staff had not had the opportunity to have supervision with their manager, so their practice when giving care and medicines had not been regularly assessed. The records relating to the care and treatment of people and the overall management of the service were had not been regularly reviewed to ensure they were of a good standard. We have identified one breach in the regulations. You can see what action we have asked the provider to take at the back of this report.

Care plans were based around tasks staff needed to complete, rather than people’s personal preferences. They gave staff brief guidance on what tasks they needed to complete, and therefore were not person centred.

Staff had a positive and caring attitude about their jobs. People told us that they were happy with the care and support they received. A person said, “They (staff) are loving and caring people, and they know what they are doing.” All the staff we spoke with were happy in their work and proud of the job they do.

People received a safe service from IRC Care Services Ltd. There were sufficient numbers of staff who were appropriately trained to meet the needs of the people. Staff worked in geographic areas to minimise the impact of travel times between each call.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding board or the police.

Staff recruitment procedures were safe. The provider had undertaken appropriate safety checks to ensure that only suitable staff were employed to support people in their own home. Staff said they felt supported to undertake their roles. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

Staff managed the medicines in a safe way and were trained in the safe administration of medicines. The majority of people were prompted by staff to take their medicines, but where staff gave people their medicine this was done in a safe way.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed.

People were supported to have enough to eat and drink. They received support from staff where a need had been identified. People’s dietary support needs were recorded and met by the staff.

People were supported to maintain good health. When people’s health deteriorated staff responded quickly and made sure they contact